ABSTRACT

Objective : The purpose of this study was to investigate the manual ability of children with spastic cerebral palsy using Manual Ability Classification System(MACS) and to analyze the relationship between the level of MACS and self-care skills. Methods : Forty-five children with spastic cerebral palsy were endrolled in this study. To evaluate interrater reliability of MACS, one rater carried out the test to subjects and another rater scored the performances independently by observation. The main rater evaluated the self-care skills of subjects based on Pediatric Evaluation of Disability Inventory(PEDI). Inter-rater reliability was analyzed using Interclass Correlation(ICC). Spearman correlation analysis was used to evaluate the correlation between the MACS and self-care skill. Further Kruscal-Wallis test and Mann-Whitney test were performed to examine difference in the PEDI scores between the MACS levels. Results : The inter-rater reliability of the MACS was good(ICC=.93). The correlation between the MACS and self-care score was high(r=-.921). Among self-care domains, shoes/socks(r=-.852), fasteners(r=- .849) and pants(r=-.846) had the greatest correlation with the MACS levels. Three domains in self-care skills showed significant differences between the MACS level 1 and 2, four between the level 2 and 3, one between the level 3 and 4, respectively. However no domain showed difference between the level 4 and 5. Conclusions : The MACS is a reliable instrument to assess the manual ability in children with cerebral palsy. Furthermore, this study suggests that the MACS could be clinically used to predict self-care skills in children with cerebral palsy.